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COUNTRY PROFILE: SENEGAL SENEGAL COMMUNITY HEALTH PROGRAMS
DECEMBER 2013
Advancing Partners & Communities
Advancing Partners & Communities (APC) is a five-year cooperative agreement funded by the U.S.
Agency for International Development under Agreement No. AID-OAA-A-12-00047, beginning
October 1, 2012. APC is implemented by JSI Research & Training Institute in collaboration with FHI 360.
The project focuses on advancing and supporting community programs that seek to improve the overall
health of communities and achieve other health-related impacts, especially in relationship to family
planning. APC provides global leadership for community-based programming, executes and manages
small- and medium-sized sub-awards, supports procurement reform by preparing awards for execution
by USAID, and builds technical capacity of organizations to implement effective programs.
Recommended Citation
Advancing Partners & Communities. 2013. Country Profile: Senegal Community Health Programs. Arlington,
VA: Advancing Partners & Communities.
Photo Credit: Ray Witlin/World Bank
JSI RESEARCH & TRAINING INSTITUTE, INC. 1616 Fort Myer Drive, 16th Floor
Arlington, VA 22209 USA
Phone: 703-528-7474
Fax: 703-528-7480
Email: info@advancingpartners.org
Web: advancingpartners.org
This publication was produced by Advancing Partners & Communities (APC), a five-year cooperative agreement
funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-12-00047, beginning
October 1, 2012. The authors' views expressed in this publication do not necessarily reflect the views of the U.S.
Agency for International Development or the United States Government.
COUNTRY PROFILE*
SENEGAL COMMUNITY HEALTH PROGRAMS
DECEMBER 2013
* Adapted from the Health Care Improvement Project’s Assessment and Improvement Matrix for community health worker programs, and PATH’s
Country Assessments of Community-based Distribution programs.
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SENEGAL COMMUNITY HEALTH PROGRAMS
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SENEGAL COMMUNITY HEALTH PROGRAMS
TABLE OF CONTENTS
ACRONYMS..................................................................................................................... VI
I. INTRODUCTION .......................................................................................................... 1
II. GENERAL INFORMATION ........................................................................................ 1
III. COMMUNITY HEALTH WORKERS ........................................................................ 4
IV. MANAGEMENT AND ORGANIZATION .............................................................. 10
V. POLICIES ..................................................................................................................... 13
VI. INFORMATION SOURCES ..................................................................................... 14
VII. AT-A-GLANCE GUIDE TO SENEGAL COMMUNITY
HEALTH SERVICE PROVISION ................................................................................... 15
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SENEGAL COMMUNITY HEALTH PROGRAMS
ACRONYMS
ACT artemisinin-based combination therapy
AIDS acquired immunodeficiency syndrome
ASBC community-based health agents/agentes de services à base communautaires
ASC community health agents/agents de santé communautaire
CHW community health workers
DMPA injectable contraceptive Depo-Provera
FAM fertility awareness methods
FGC female genital cutting
FP family planning
HIV human immunodeficiency virus
iCCM integrated community case management
ICP health post manager/l’infirmier chef du poste de santé
IEC information, education, and communication
IM intramuscular
INGO international nongovernmental organization
IRS indoor residual spraying
IUD intrauterine devices
LAM lactational amenorrhea method
MCH maternal and child health
MNCH maternal, newborn, and child health
MOHSA Ministry of Health and Social Action
MSI Marie Stopes International
NGO nongovernmental organization
ORS oral rehydration solution
PMTCT prevention of mother-to-child transmission (of HIV)
PPH postpartum hemorrhage
PSC Community Health Project/Programme de Santé Communautaire
SDM standard days method
SP sulphadoxine-pyrimethamine (for treatment of uncomplicated malaria)
UNFPA United Nations Population Fund
VCT voluntary counseling and testing (HIV)
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SENEGAL COMMUNITY HEALTH PROGRAMS
I. INTRODUCTION
This Country Profile is the outcome of a landscape assessment conducted by Advancing Partners & Communities (APC) staff and colleagues. The
landscape assessment focused on the United States Agency for International Development (USAID) Population and Reproductive Health priority
countries, and includes specific attention to family planning as that is the core focus of the APC project. The purpose of the landscape
assessment was to collect the most up to date information available on the community health system, community health workers, and
community health services in each country. This profile is intended to reflect the information collected. Where possible, the information
presented is supported by national policies and other relevant documents; however, much of the information is the result of institutional
knowledge and personal interviews due to the relative lack of publicly available information on national community health systems. As a result,
gaps and inconsistencies may exist in this profile. If you have information to contribute, please submit comments to info@advancingpartners.org.
APC intends to update these profiles regularly, and welcomes input from our colleagues.
II. GENERAL INFORMATION
1 What is the name of this program*, and who
supervises it (Government, nongovernmental
organizations (NGOs), combination, etc.)?
Please list all that you are aware of.
*If there are multiple programs, please add
additional columns to the right to answer the
following questions according to each community
health program.
1
2 How long has this program been in operation?
What is its current status (pilot, scaling up,
nationalized, non-operational)?
1 Such as ChildFund and their partners Africare, Plan, World Vision, Catholic Relief Services, and two Senegalese partners.
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SENEGAL COMMUNITY HEALTH PROGRAMS
3 Where does this program operate? Please note
whether these areas are urban, peri-urban,
rural, or pastoral. Is there a focus on any
particular region or setting?
Please note specific districts/regions, if known.
4 If there are plans to scale up the community
health program, please note the scope of the
scale-up (more districts, regional, national, etc.)
as well as location(s) of the planned future
implementation sites.
5 Please list the health services delivered by
community health workers (CHWs2) under this
program. Are these services part of a defined
package? Do these services vary by region?
6 Are FP services included in the defined package,
if one exists?
7 Please list the FP services and methods delivered by CHWs.
2 The term “CHW” is used as a generic reference for community health workers for the purposes of this landscaping exercise. Country-appropriate terminology for community health workers is
noted in the response column.
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SENEGAL COMMUNITY HEALTH PROGRAMS
8 What is the general service delivery system
(e.g. how are services provided? Door-to-door,
via health posts/other facilities, combination)?
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SENEGAL COMMUNITY HEALTH PROGRAMS
III. COMMUNITY HEALTH WORKERS
9 Are there multiple cadre(s) of health
workers providing services at the
community level? If so, please list them
by name and note hierarchy.
10 Do tasks/responsibilities vary among
CHWs? How so (by cadre,
experience, age, etc.)?
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SENEGAL COMMUNITY HEALTH PROGRAMS
11 Total number of CHWs in program?
Please break this down by cadre, if
known, and provide goal and estimated
actual numbers. Please note how many
are active/inactive, if known.
12 Criteria for CHWs (e.g. age, gender,
education level, etc.)?
Please break this down by cadre, if
known.
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SENEGAL COMMUNITY HEALTH PROGRAMS
13 How are the CHWs trained? Please
note the length, frequency, and
requirements of training.
Please break this down by cadre, if
known.
Is any training certification given at the
completion of training?
14 Do the CHWs receive comprehensive
training for all of their responsibilities
at once, or is training conducted over
time? How does this impact their
ability to deliver services?
15 Please note the health services
provided by the various cadre(s) of
CHW, as applicable (i.e. who can
provide what service).
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SENEGAL COMMUNITY HEALTH PROGRAMS
16 Please list which family planning
services are provided by which
cadre(s), as applicable.
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SENEGAL COMMUNITY HEALTH PROGRAMS
17 Do CHWs distribute commodities in
their communities (i.e. zinc tablets, FP
methods, etc.)? Which
programs/products?
18 Are CHWs paid, are incentives
provided, or are they volunteers?
Are the incentives or pay performance-
based?
Please differentiate by cadre, as
applicable.
19 Who is responsible for these
incentives (MOHSA, NGO,
municipality, combination)?
20 Do CHWs work in urban and/or rural
areas?
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SENEGAL COMMUNITY HEALTH PROGRAMS
21 Are CHWs residents of the
communities they serve? Were they
residents before becoming CHWs (i.e.
are they required to be a member of
the community they serve)?
22 Describe the geographic
coverage/catchment area for each
CHW.
23 How do CHWs get to their clients
(walk, bike, public transport, etc.)?
24 Describe the CHW role in data
collection and monitoring.
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SENEGAL COMMUNITY HEALTH PROGRAMS
IV. MANAGEMENT AND ORGANIZATION
25 Does the community health program
have a decentralized management
system? If so, what are the levels (state
government, local government, etc.)?
26 Is the MOHSA responsible for the
program, overall?
27 What level of responsibility do
regional, state, or local governments
have for the program, if any?
Please note responsibility by level of
municipality.
28 What level of responsibility do international and local NGOs have for
the program, if any?
29 Are CHWs linked to the health
system? Please describe the
mechanism.
30 Who supervises CHWs? What is the
supervision process? Does the
government share supervision with an
NGO/NGOs? If so, please describe
how they share supervision
responsibilities.
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SENEGAL COMMUNITY HEALTH PROGRAMS
31 Where do CHWs refer clients for the
next tier of services? Do lower-level
cadres refer to the next cadre up (of
CHW) at all?
32 Where do CHWs refer clients
specifically for FP services?
Please note by method.
33 Are CHWs linked to other community
outreach programs?
34 What mechanisms exist for knowledge
sharing among CHWs/supervisors?
35 What links exist to other institutions
(schools, churches, associations, etc.)?
36 Do vertical programs have separate
CHWs or "share/integrated"?
37 Do they have data collection/reporting
systems?
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SENEGAL COMMUNITY HEALTH PROGRAMS
38 Describe any financing schemes that
may be in place for the program (e.g.
donor funding/MOHSA
budget/municipal budget/health center
user fees/direct user fees).
39 How and where do CHWs access the
supplies they provide to clients
(medicines, FP products, etc.)?
40 How and where do CHWs dispose of
medical waste generated through their
services (used needles, etc.)?
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SENEGAL COMMUNITY HEALTH PROGRAMS
V. POLICIES
41 Is there a stand-alone community health
policy? If not, is one underway or under
discussion?
Please provide a link if available online.
42 Is the community health policy integrated
within overall health policy?
43 When was the last time the community
health policy was updated?
(months/years?)
44 What is the proposed geographic scope of
the program, according to the policy?
(Nationwide? Select regions?)
45 Does the policy specify which services can
be provided by CHWs, and which cannot?
46 Are there any policies specific to FP
service provision (e.g. CHWs allowed to
inject contraceptives)?
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SENEGAL COMMUNITY HEALTH PROGRAMS
VI. INFORMATION SOURCES
CCM Central. 2013. “MCHIP Documentation of Mature National iCCM Programs; the Case of Senegal.” Available at www.ccmcentral.com/?q=node/317
(accessed August 2013).
Ennulat, Christine. 2012. ”Expanding Community Health Care Access in Senegal.” Child Fund International. Available at www.childfund.org/Senegal-Community-Health-Grant/
(accessed August 2013).
FHI 360. 2013. Documentation du Processus de l’Offre Initiale de Pilule (OIP) par les Matrones des Cases de Santé au Sénégal. fhi360, for the Ministère de la Santé et de la Prévention
Division de la Santé de la Reproduction and the U.S. Agency for International Development.
FHI 360. 2013. Senegal: Pilot Study Shows Community Health Workers Successfully Provide Intramuscular Injectable Contraception.
MEASURE DHS. 2012. Senegal: DHS 2010-2011 Fact Sheet (French). Available at www.measuredhs.com/publications/publication-GF27-General-Fact-Sheets.cfm
(accessed November 2013).
Ministry of Health and Social Action (MOHSA) Community Health Unit staff. Unpublished communication. August 2013.
Republic of Senegal, Ministry of Health and Prevention. 2009. Plan National de Developpement Sanitaire 2009-2018. Dakar: Ministry of Helath and Prevention. Available at
http://www.sante.gouv.sn/images/stories/pdf/pndsdixhuit.pdf (accessed November 2013).
Republic of Senegal, Ministry of Health and Social Action. n.d. Plan d’Action National de Planification Familiale 2012-2015. Ministry of health and Social Action. Available at
http://www.fhi360.org/sites/default/files/media/documents/senegal-plan-action-national-planification-familiale-2012-2015.pdf (access November 2013).
Sanogo, Diouratié, Mady Cisse, Médecin-Colonel Adama Ndoye, et al. 2004. Étude Expérimentale sur l’offre de la Distribution à Base Communautaire des Services de Santé de la
Reproduction au Sénégal. Population Council, for the Ministry of Health, Division of Reproductive Health (DSR); Management Sciences for Health (MSH); Health District
of Kébémer.
United Nations Population Fund (UNFPA). 2012. The Global Programme to Enhance Reproductive Health Commodity Security. Annual Report 2011.
U.S. Agency for International Development (USAID) Sénégal. 2010. Offre Initiale de la Pilule Contraceptive Par les Matrones des Cases de Santé. Conférence National sur les
Initiatives à Base Communautaire en SR/PF.
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SENEGAL COMMUNITY HEALTH PROGRAMS
VII. AT-A-GLANCE GUIDE TO SENEGAL
COMMUNITY HEALTH SERVICE PROVISION
Relais communautaires are not included in the service provision tables below, as they provide outreach and follow-up on behalf of the health
center for clients already seen, and do not provide specific health services.
Intervention Matrones Agentes de Santé Communautaires
Family
Planning
Services/Products Information/
education
Counseling Administered and/or
provided product
Referral Information/
education
Counseling Administered and/or
provided product
Referral
SDM/FAM X X X X X X
Condoms X X X X X X
Oral pills X X X X X X
DMPA (IM) X X
X
(pilot sites only) X X
X
(pilot sites only)
Implants X X X X X X
IUDs X X X X X X
Permanent
methods X X X X X X
Emergency
contraception
HIV/AIDS Voluntary
counseling and
testing (VCT)
Prevention of
mother-to-child
transmission
(PMTCT)
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SENEGAL COMMUNITY HEALTH PROGRAMS
Maternal
and child
health
(MCH)
Misoprostol (for
prevention of
postpartum
hemorrhage -
PPH)
X X X
Antenatal care
Postnatal care
Zinc X X X X X X
ORS X X X X X X
Immunizations X X X X X X
Malaria Bed nets
IRS
Sulphadoxine-
pyrimethamine
(for treatment of
uncomplicated
malaria) (SP)
ACT X X X X X X
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SENEGAL COMMUNITY HEALTH PROGRAMS
Intervention Agentes de Services à Base Communautaires Relais Communautaires
Family
Planning
Services/Products Information/
education
Counseling Administered and/or
provided product
Referral Information/
education
Counseling Administered and/or
provided product
Referral
SDM/FAM X X X
Condoms X X X
Oral pills X X
X
(resupply only)
X
(initial only)
DMPA (IM) X X X
Implants X X X
IUDs X X X
Permanent
methods X X
Emergency
Contraception
HIV/AIDS VCT
PMTCT
MCH Misoprostol (for
PPH)
Antenatal care
Postnatal care
Zinc
ORS
Immunizations
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SENEGAL COMMUNITY HEALTH PROGRAMS
Malaria Bed nets
IRS
SP
ACT
Intervention Badienou Gokh
Family
Planning
Services/Products Information/ education Counseling Administered and/or provided product Referral
SDM/FAM
Condoms
Oral pills
DMPA (IM)
Implants
IUDs
Permanent
methods
HIV/AIDS VCT
PMTCT
Malaria Bed nets
IRS
SP
ACT for malaria
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SENEGAL COMMUNITY HEALTH PROGRAMS
ADVANCING PARTNERS & COMMUNITIES
JSI RESEARCH & TRAINING INSTITUTE
1616 Fort Myer Drive, 16th Floor
Arlington, VA 22209 USA
Phone: 703-528-7474
Fax: 703-528-7480
Web: advancingpartners.org
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